Register as a new customer

Please fill out all fields marked with ***.
Once you have registered yourself and your password you can then add your delivery addresses and payment details. We try to keep all of our forms to a minimum to make registering as simple as possible.

Enter your details

Your name

Title

Forename

***

Surname

***

Your account username and password

e-mail address

***This will be your username as well

Confirm e-mail address

***

Password

Must be at least 6 characters ***

Confirm Password

Type your password again ***

Important: Your contact details

Contact Telephone No

***We need your phone number so that we can contact youimmediately if we have any problems with your order

Mobile No

Your address

Company Name

see below for trade status application

Address

***

Town / City

***

County / Region

Postcode:

***

Country

***If your country is not listed then please contact us for delivery details

Other Information

How did you hear about us?

e.g. Google search, link, referral, returning customer

Cocoa Mountain Account Number

(if you have used Cocoa Mountain before)

Mailing PreferencesRemove this tick if you would not like to receive periodic emails from Cocoa Mountain about special offers and new products and are happy to pay full price. You will never get unsolicited email from Cocoa Mountain.